RESUMEN

This study aimed to evaluate an immunochromatographic test used to detect glutamate dehydrogenase (GDH) for the diagnosis of Clostridium difficile infection (CDI) in dogs. Fecal samples of 119 diarrheic dogs were subjected to toxigenic culture as the "gold standard" method and to GDH detection (Ecodiagnostica, Brazil). Samples positive for toxigenic C. difficile strains and those positive in the GDH test were also subjected to A/B toxin detection using an enzyme immunoassay kit (C. difficile Tox A/B II, Techlab Inc., USA). Sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) were measured for GDH detection and compared with the toxigenic culture results. A total of 19 (15.9%) dogs were positive for toxigenic C. difficile. Of these, 10 (52.6%) dogs were positive for A/B toxins using the enzyme immunoassay kit and 18 (15.2%) were positive in the GDH test, leading to a sensitivity and NPV of 89.4% and 97.9%, respectively. Three animals, two of which were colonized with non-toxigenic strains, were positive for GDH, though not confirmed with CDI, resulting in a high specificity (97%) and PPV (85%). The results suggest that the lateral flow test for GDH detection could be a useful method for diagnosing CDI in dogs, similar to that previously described for humans and other animal species.

Asunto(s)

Infecciones por Clostridium , Glutamato Deshidrogenasa/aislamiento & purificación , Inmunoensayo/veterinaria , Animales , Proteínas Bacterianas , Toxinas Bacterianas , Clostridioides difficile , Infecciones por Clostridium/diagnóstico , Infecciones por Clostridium/veterinaria , Perros/microbiología , Enterotoxinas , Heces , Sensibilidad y Especificidad

RESUMEN

Described in surgical patients after antibiotic use in the 1950s and 1960s, Staphylococcus aureus (S. aureus) enterocolitis is a rare form of nosocomial diarrhea. However, S. aureus is not routinely tested like Clostridium difficile (C. difficile). We report a case of methicillin-resistant S. aureus (MRSA) enterocolitis found on stool culture in a 22-week pregnant female with a previously negative nasal MRSA culture, and a total burn surface area greater than 60%. She also developed necrotizing MRSA pneumonia and bacteremia. After starting broad-spectrum antibiotic for the necrotizing pneumonia with subsequent acute respiratory distress syndrome, the patient exhibited large voluminous diarrhea that tested positive for MRSA and negative for C. difficile in the stool culture. Similar to other reports of high-volume diarrhea, the diarrhea resolved quickly with enteral vancomycin. S. aureus should be considered along with C. difficile during the workup of nosocomial diarrhea, especially with exposure to broad-spectrum antibiotics in the critically ill patient.

RESUMEN

Clostridioides (Clostridium) difficile is responsible for most cases of nosocomial diarrhea and, despite the high prevalence of the disease worldwide, the best laboratory diagnostic approach to diagnose C. difficile infection (CDI) is a subject of ongoing debate. Although the use of multiple tests is recommended, the cost of these algorithms commonly exceeds the affordability in some countries. Thus, to improve CDI diagnosis in a university hospital in Brazil, this study analyzed two immunochromatographic tests and one enzyme immunoassay (ELISA) to evaluate the detection of glutamate dehydrogenase (GDH) and A/B toxins of C. difficile. Stool samples of 89 adult patients presenting nosocomial diarrhea during hospitalization were included. The toxigenic culture was used as the reference method. GDH detection by both commercial tests showed high sensitivity (100%) and specificity (92.1%). On the other hand, toxin-based methods showed a sensitivity between 19.2 and 57.7%. In conclusion, the results suggest that rapid tests for GDH detection are not only suitable for CDI diagnosis as screening tests but also as a single method.

Asunto(s)

Proteínas Bacterianas/análisis , Toxinas Bacterianas/análisis , Clostridioides difficile/enzimología , Infecciones por Clostridium/diagnóstico , Ensayo de Inmunoadsorción Enzimática/métodos , Glutamato Deshidrogenasa/análisis , Inmunoensayo/métodos , Proteínas Bacterianas/metabolismo , Toxinas Bacterianas/metabolismo , Brasil , Clostridioides , Clostridioides difficile/química , Clostridioides difficile/metabolismo , Infecciones por Clostridium/microbiología , Pruebas Diagnósticas de Rutina/métodos , Glutamato Deshidrogenasa/metabolismo , Hospitales Universitarios , Humanos

RESUMEN

Considering the lack of studies evaluating the performance of commercially available methods for diagnosis of Clostridioides (Clostridium) difficile infection (CDI) in animals, the present study aimed to assess an immunochromatographic test for detection of glutamate dehydrogenase (GDH) and A/B toxins of C. difficile, also evaluated by an ELISA kit, in foals and neonatal piglets. Intestinal contents of 47 piglets and feces of 35 foals were tested to GDH antigen and A/B toxins in a lateral flow method (Ecodiagnostica, Brazil). Also, these samples were submitted to A/B toxin detection by an ELISA kit (C. difficile Tox A/B II, Techlab Inc., USA), using the toxigenic culture (TC) as the reference method. The GDH component of the lateral flow test showed sensitivity and negative predictive value (NPV) of 100% and a high specificity in samples of piglets (82.61%) and foals (100%). Detection of A/B toxins using the lateral flow test and the ELISA resulted in a specificity of 100% in samples of both species. On the other hand, the sensibility ranged from 54.2 to 90% for the ELISA and from 12.5 to 60% for the lateral flow test for piglets' and foals' samples, respectively. In conclusion, the present work suggests that the lateral flow test for GDH detection could be a useful method for diagnosing CDI in these species. On the other hand, the low sensitivity of the lateral flow test for A/B toxins might compromise its utility in piglets.

Asunto(s)

Toxinas Bacterianas/análisis , Clostridioides difficile/aislamiento & purificación , Diarrea/veterinaria , Ensayo de Inmunoadsorción Enzimática/métodos , Glutamato Deshidrogenasa/análisis , Enfermedades de los Caballos/microbiología , Inmunoensayo/métodos , Enfermedades de los Porcinos/microbiología , Animales , Animales Recién Nacidos/microbiología , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Toxinas Bacterianas/metabolismo , Brasil , Clostridioides difficile/enzimología , Clostridioides difficile/metabolismo , Infecciones por Clostridium/diagnóstico , Infecciones por Clostridium/microbiología , Infecciones por Clostridium/veterinaria , Diarrea/diagnóstico , Diarrea/microbiología , Heces/microbiología , Glutamato Deshidrogenasa/metabolismo , Enfermedades de los Caballos/diagnóstico , Caballos , Inmunoensayo/veterinaria , Porcinos , Enfermedades de los Porcinos/diagnóstico

RESUMEN

The molecular epidemiology of 38 non-duplicate toxigenic Clostridioides (previously Clostridium) difficile isolates from inpatients from a hospital in Brazil during a 6-year period (2012-2017) were investigated by multilocus sequence typing (MLST) and ribotyping. These isolates were classified into 20 sequence types (ST), six (30%) of which were novel, revealing a high diversity in a single hospital. Classic hypervirulent strains ST1/RT027 and ST11/RT078 were not identified, while ST42 (almost all RT106) was the most common type, being detected in 11 (28.9%) strains. Noteworthy, six (15.8%) isolates were classified into five STs from clade 2, four of which were new ST and RT. Our study suggests that possible hypervirulent strains other than ST1/RT027 might be inadvertently circulating in Brazilian hospitals and highlights the importance of permanent surveillance on circulating strains in a national scale.

Asunto(s)

Clostridioides difficile/clasificación , Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/epidemiología , Infecciones por Clostridium/microbiología , Genotipo , Brasil/epidemiología , Clostridioides difficile/genética , Hospitales Universitarios , Pacientes Internos , Epidemiología Molecular , Tipificación de Secuencias Multilocus , Ribotipificación

RESUMEN

INTRODUCTION: The prevalence of Clostridium difficile infection is rapidly increasing worldwide, but prevalence is difficult to estimate in developing countries where awareness, diagnostic resources, and surveillance protocols are limited. As diarrhea is the hallmark symptom, we conducted a systematic review and meta-analysis to determine the prevalence and incidence of C. difficile infection in patients in these regions who presented with diarrhea. METHODS: We conducted a systematic literature search of MEDLINE/PubMed, Scopus, and Latin-American and Caribbean Health Sciences Literature databases to identify and analyze data from recent studies providing prevalence or incidence rates of C. difficile-associated diarrhea in developing countries within four regions: Africa-Middle East, developing Asia, Latin America, and China. Our objectives were to determine the current prevalence and incidence density rates of first episodes of C. difficile-associated diarrhea in developing countries. RESULTS: Within the regions included in our analysis, prevalence of C. difficile infection in patients with diarrhea was 15% (95% CI 13-17%) (including community and hospitalized patients), with no significant difference across regions. The incidence of C. difficile infection in 17 studies including this information was 8.5 per 10,000 patient-days (95% CI 5.83-12.46). Prevalence was significantly higher in hospitalized patients versus community patients (p  = 0.0227). CONCLUSION: Our prevalence estimate of 15% is concerning; however, low awareness and inconsistent diagnostic and surveillance protocols suggest this is markedly underestimated. Enhanced awareness and management of C. difficile infection in patients with diarrhea, along with improvements in infection control and surveillance practices, should be implemented to reduce prevalence of C. difficile-associated diarrhea in developing countries. FUNDING: Pfizer Inc.

RESUMEN

C. difficile is an anaerobic spore former pathogen and the most important etiologic agent of nosocomial and community acquired antibiotics associated diarrheas. C. difficile infections (CDI) are responsible for an elevated rate of morbidity in developed and developing countries. Although the major virulence factors responsible for clinical symptoms of CDI are the two toxins TcdA and TcdB, C. difficile spores are the main vehicle of infection, persistence and transmission of CDI. Recent work has unrevealed unique properties of C. difficile spores that make them remarkable morphotypes of persistence and transmission in the host, including their resistance to antibiotics, the host immune response and disinfectants. The present review summarizes relevant aspects of C. difficile spore biology that have major implications from a clinical and medical perspective.

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Clostridium difficile es un patógeno anaerobio, formador de esporas y el agente etiológico más importante de las diarreas asociadas a antimicrobianos, tanto nosocomiales como adquiridas en la comunidad. Las infecciones asociadas a C. difficile poseen una elevada tasa de morbilidad en países desarrollados y en vías de desarrollo. Los dos factores de virulencia principales son TcdA y TcdB, toxinas que causan la remodelación del citoesqueleto lo cual desencadena los síntomas clínicos asociados a esta enfermedad infecciosa. A pesar que las esporas de C. difficile son el principal vehículo de infección, persistencia en el hospedero y de transmisión, pocos estudios se han enfocado sobre este clave aspecto. Es altamente probable que la espora juegue roles esenciales en los episodios de recurrencia y de transmisión horizontal de la infección por este microorganismo. Estudios recientes han revelado características únicas de las esporas de C. difficile que las hacen capaces de ser altamente transmisibles y persistir dentro del hospedero. Más aún, algunas de estas propiedades están relacionadas con la resistencia de sus esporas a los desinfectantes más comúnmente usados en los recintos hospitalarios. La presente revisión resume los conocimientos más relevantes en la biología de las esporas de C. difficile, con un énfasis en aquellos aspectos con implicancias clínicas, incluido el control de infecciones en el ambiente hospitalario.

Asunto(s)

Humanos , Infecciones por Clostridium/microbiología , Clostridioides difficile/patogenicidad , Infección Hospitalaria/microbiología , Esporas Bacterianas/patogenicidad , Infecciones por Clostridium/transmisión , Infección Hospitalaria/transmisión , Diarrea/microbiología , Factores de Virulencia

RESUMEN

O objetivo do presente trabalho foi padronizar um modelo de infecção por Clostridium difficile (ICD) em hamsters sírios (Mesocricetus auratus). Para seleção dos isolados capazes de causar letalidade, cinco animais por grupo receberam uma dose de clindamicina (30mg kg-1) por gavagem. Após 48 horas, administraram-se 107 unidades formadoras de colônia (UFC), por animal, de quatro diferentes isolados toxigênicos de C. difficile. Selecinou-se um dos isolados capazes de causar diarreia e letalidade e administrou-se 4x102; 4x104; 4x106; 4x108UFC por animal, novamente com cinco hamsters por grupo. Em todas as diluições testadas, foi possível observar a ocorrência de diarreia e morte. A maior concentração testada (4x108UFC por animal) causou óbito de 100% dos hamsters do grupo. Todos os animais que vieram a óbito apresentaram tiflite hemorrágica, foram positivos para as toxinas A/B e foi possível isolar C. difficile do conteúdo intestinal, confirmando a reprodução experimental da doença. A dose letal para 50% da população foi estabelecida em 6,3x104UFC por animal. O modelo de indução de ICD em hamsters descritos no presente estudo passa a ser uma ferramenta valiosa para estudos relativos à patogenia, tratamento e controle dessa doença.(AU)

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The aim of this study was to standardize a model of Clostridium difficile infection (CDI) in Syrian hamsters (Mesocricetus auratus). In order to evaluate strains capable of causing lethality, five hamsters per group received clindamycin (30mg kg-1) by gavage. After 48 hours, 107 colony forming units (CFU) of spores' solution of four strains were administered per animal. One strain capable of causing diarrhea and death was selected and administered at the following concentrations: 4x102; 4x104; 4x106; 4x108 CFU per animal. All dilutions tested were able to cause diarrhea and death. The highest concentration showed 100% of mortality. Post mortem evaluation revealed hemorrhagic typhlitis in all death animals. In addition, all intestinal contents were positive for A/B toxins, and toxigenic C. difficile strains were isolated, confirming the induction of infection by this microorganism. The dose lethal to 50% of the population was calculated: 6.3x104 CFU per animal. The standardized model of CDI in hamster is now available for studies on pathogenesis, treatment and control of this disease.(AU)

Asunto(s)

Animales , Ratas , Clostridioides difficile/patogenicidad , Infecciones por Clostridium/veterinaria , Mesocricetus

RESUMEN

O objetivo do presente trabalho foi padronizar um modelo de infecção por Clostridium difficile (ICD) em hamsters sírios (Mesocricetus auratus). Para seleção dos isolados capazes de causar letalidade, cinco animais por grupo receberam uma dose de clindamicina (30mg kg-1) por gavagem. Após 48 horas, administraram-se 107 unidades formadoras de colônia (UFC), por animal, de quatro diferentes isolados toxigênicos de C. difficile. Selecinou-se um dos isolados capazes de causar diarreia e letalidade e administrou-se 4x102; 4x104; 4x106; 4x108UFC por animal, novamente com cinco hamsters por grupo. Em todas as diluições testadas, foi possível observar a ocorrência de diarreia e morte. A maior concentração testada (4x108UFC por animal) causou óbito de 100% dos hamsters do grupo. Todos os animais que vieram a óbito apresentaram tiflite hemorrágica, foram positivos para as toxinas A/B e foi possível isolar C. difficile do conteúdo intestinal, confirmando a reprodução experimental da doença. A dose letal para 50% da população foi estabelecida em 6,3x104UFC por animal. O modelo de indução de ICD em hamsters descritos no presente estudo passa a ser uma ferramenta valiosa para estudos relativos à patogenia, tratamento e controle dessa doença.

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The aim of this study was to standardize a model of Clostridium difficile infection (CDI) in Syrian hamsters (Mesocricetus auratus). In order to evaluate strains capable of causing lethality, five hamsters per group received clindamycin (30mg kg-1) by gavage. After 48 hours, 107 colony forming units (CFU) of spores' solution of four strains were administered per animal. One strain capable of causing diarrhea and death was selected and administered at the following concentrations: 4x102; 4x104; 4x106; 4x108 CFU per animal. All dilutions tested were able to cause diarrhea and death. The highest concentration showed 100% of mortality. Post mortem evaluation revealed hemorrhagic typhlitis in all death animals. In addition, all intestinal contents were positive for A/B toxins, and toxigenic C. difficile strains were isolated, confirming the induction of infection by this microorganism. The dose lethal to 50% of the population was calculated: 6.3x104 CFU per animal. The standardized model of CDI in hamster is now available for studies on pathogenesis, treatment and control of this disease.

RESUMEN

The objective of this study was to evaluate antimicrobial susceptibility in Clostridium difficile strains isolated from animals and humans in Brazil. The 54 C. difficile strains used were isolated from stool samples from piglets (n=16), dogs (n=13), humans (n=13), foals (n=8) calves (n=2), an ocelot (n=1) and a maned wolf (n=1). Antimicrobial susceptibility was determined using the serial plate agar dilution method for penicillin, florfenicol, oxytetracycline, erythromycin, vancomycin, metronidazole and tylosin. The C. difficile strains assessed were susceptible to metronidazole and vancomycin. Florfenicol resistance was rarely observed; 52 (96.4%) strains were sensitive to this antimicrobial. Five (9.3%), five (9.3%), 14 (25.9%) and 20 (37.0%) strains were resistant to oxytetracycline, penicillin, tylosin and erythromycin respectively.

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O objetivo do presente trabalho foi avaliar a sensibilidade antimicrobiana de estirpes de Clostridium difficile isoladas de animais e humanos no Brasil. Foram utilizados 54 estirpes de C. difficile isoladas de fezes de leitões (n=16), cães (n=13), seres humanos (n=13), potros (n=8), bezerros (n=2), jaguatirica (n=1) e um lobo-guará (n=1). A sensibilidade antimicrobiana foi determinada pelo método de diluição seriada em ágar para penicilina, florfenicol, oxitetraciclina, eritromicina, vancomicina, metronidazol e tilosina. Todos os isolados foram sensíveis ao metronidazol e á vancomicina. Resistência ao florfenicol foi rara, sendo que 52 (96,4%) das estirpes foram sensíveis a esse antimicrobiano. Cinco (9,3%), cinco (9,3%), 14 (25,9%) e 20 (37,0%) foram resistentes a oxitetraciclina, penicilina, tilosina e eritromicina, respectivamente.

RESUMEN

The objective of this study was to evaluate antimicrobial susceptibility in Clostridium difficile strains isolated from animals and humans in Brazil. The 54 C. difficile strains used were isolated from stool samples from piglets (n=16), dogs (n=13), humans (n=13), foals (n=8) calves (n=2), an ocelot (n=1) and a maned wolf (n=1). Antimicrobial susceptibility was determined using the serial plate agar dilution method for penicillin, florfenicol, oxytetracycline, erythromycin, vancomycin, metronidazole and tylosin. The C. difficile strains assessed were susceptible to metronidazole and vancomycin. Florfenicol resistance was rarely observed; 52 (96.4%) strains were sensitive to this antimicrobial. Five (9.3%), five (9.3%), 14 (25.9%) and 20 (37.0%) strains were resistant to oxytetracycline, penicillin, tylosin and erythromycin respectively.(AU)

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O objetivo do presente trabalho foi avaliar a sensibilidade antimicrobiana de estirpes de Clostridium difficile isoladas de animais e humanos no Brasil. Foram utilizados 54 estirpes de C. difficile isoladas de fezes de leitões (n=16), cães (n=13), seres humanos (n=13), potros (n=8), bezerros (n=2), jaguatirica (n=1) e um lobo-guará (n=1). A sensibilidade antimicrobiana foi determinada pelo método de diluição seriada em ágar para penicilina, florfenicol, oxitetraciclina, eritromicina, vancomicina, metronidazol e tilosina. Todos os isolados foram sensíveis ao metronidazol e á vancomicina. Resistência ao florfenicol foi rara, sendo que 52 (96,4%) das estirpes foram sensíveis a esse antimicrobiano. Cinco (9,3%), cinco (9,3%), 14 (25,9%) e 20 (37,0%) foram resistentes a oxitetraciclina, penicilina, tilosina e eritromicina, respectivamente.(AU)

Asunto(s)

Humanos , Animales , Clostridioides difficile/aislamiento & purificación , Antiinfecciosos , Resistencia a Medicamentos

RESUMEN

The objective of this study was to detect C. difficile A/B toxins and to isolate strains of C. perfringens and C. difficile from diarrheic and non-diarrheic dogs in Brazil. Stool samples were collected from 57 dogs, 35 of which were apparently healthy, and 22 of which were diarrheic. C. difficile A/B toxins were detected by ELISA, and C. perfringens and C. difficile were identified by multiplex PCR. C. difficile A/B toxins were detected in 21 samples (36.8%). Of these, 16 (76.2%) were from diarrheic dogs, and five (23.8%) were from non-diarrheic dogs. Twelve C. difficile strains (21.1%) were isolated, of which ten were A(+)B(+) and two were A(-)B(-). All non-toxigenic strains were isolated from non-diarrheic animals. The binary toxin gene cdtB was found in one strain, which was A(+)B(+) and was derived from a non-diarrheic dog. C. perfringens strains were isolated from 40 samples (70.2%). Of these, 18 (45%) were from the diarrheic group, and 22 (55%) belonged to the non-diarrheic group. All isolates were classified as C. perfringens type A and there was an association between the detection of the cpe gene and the presence of diarrhea. Interestingly, ten strains (25%) were positive for the presence of the cpb2 gene. The high rate of detection of the A/B toxins in non-diarrheic dogs suggests the occurrence of subclinical disease in dogs or carriage of its toxins without disease. More studies are needed to elucidate the epidemiology of C. difficile and C. perfringens in dogs and to better our understanding of C. difficile as a zoonotic agent. This is the first study to report the binary toxin gene in C. difficile strains isolated from dogs in Brazil.

RESUMEN

The objective of this study was to detect C. difficileA/B toxins and to isolate strains of C. perfringensand C. difficile from diarrheic and non-diarrheic dogs in Brazil. Stool samples were collected from 57 dogs, 35 of which were apparently healthy, and 22 of which were diarrheic. C. difficileA/B toxins were detected by ELISA, and C. perfringensand C. difficilewere identified by multiplex PCR. C. difficileA/B toxins were detected in 21 samples (36.8%). Of these, 16 (76.2%) were from diarrheic dogs, and five (23.8%) were from non-diarrheic dogs. Twelve C. difficile strains (21.1%) were isolated, of which ten were A+B+and two were A-B-. All non-toxigenic strains were isolated from non-diarrheic animals. The binary toxin gene cdtBwas found in one strain, which was A+B+and was derived from a non-diarrheic dog. C. perfringensstrains were isolated from 40 samples (70.2%). Of these, 18 (45%) were from the diarrheic group, and 22 (55%) belonged to the non-diarrheic group. All isolates were classified as C. perfringenstype A and there was an association between the detection of the cpegene and the presence of diarrhea. Interestingly, ten strains (25%) were positive for the presence of the cpb2gene. The high rate of detection of the A/B toxins in non-diarrheic dogs suggests the occurrence of subclinical disease in dogs or carriage of its toxins without disease. More studies are needed to elucidate the epidemiology of C. difficileand C. perfringensin dogs and to better our understanding of C. difficileas a zoonotic agent. This is the first study to report the binary toxin gene in C. difficilestrains isolated from dogs in Brazil.(AU)

Asunto(s)

Animales , Toxicología , Diarrea/patología , Colitis/patología , Enteritis/patología , Perros/clasificación

RESUMEN

The objective of this study was to detect C. difficileA/B toxins and to isolate strains of C. perfringensand C. difficile from diarrheic and non-diarrheic dogs in Brazil. Stool samples were collected from 57 dogs, 35 of which were apparently healthy, and 22 of which were diarrheic. C. difficileA/B toxins were detected by ELISA, and C. perfringensand C. difficilewere identified by multiplex PCR. C. difficileA/B toxins were detected in 21 samples (36.8%). Of these, 16 (76.2%) were from diarrheic dogs, and five (23.8%) were from non-diarrheic dogs. Twelve C. difficile strains (21.1%) were isolated, of which ten were A+B+and two were A-B-. All non-toxigenic strains were isolated from non-diarrheic animals. The binary toxin gene cdtBwas found in one strain, which was A+B+and was derived from a non-diarrheic dog. C. perfringensstrains were isolated from 40 samples (70.2%). Of these, 18 (45%) were from the diarrheic group, and 22 (55%) belonged to the non-diarrheic group. All isolates were classified as C. perfringenstype A and there was an association between the detection of the cpegene and the presence of diarrhea. Interestingly, ten strains (25%) were positive for the presence of the cpb2gene. The high rate of detection of the A/B toxins in non-diarrheic dogs suggests the occurrence of subclinical disease in dogs or carriage of its toxins without disease. More studies are needed to elucidate the epidemiology of C. difficileand C. perfringensin dogs and to better our understanding of C. difficileas a zoonotic agent. This is the first study to report the binary toxin gene in C. difficilestrains isolated from dogs in Brazil.

Asunto(s)

Animales , Perros , Técnicas de Laboratorio Clínico , Clostridium perfringens , Clostridioides difficile/genética , Clostridioides difficile/aislamiento & purificación , Diarrea/genética , Enterocolitis Seudomembranosa , Impactación Fecal/genética , Reacción en Cadena de la Polimerasa , Toxinas Bacterianas/genética , Toxinas Bacterianas/aislamiento & purificación , Diagnóstico , Inmunoensayo , Métodos , Esporas Bacterianas , Virulencia

RESUMEN

Despite of the substantial role of Clostridium difficile in causing diarrhea and colitis in foals, there have been no confirmed diagnoses of disease caused by this bacteria in Brazil. In this paper, we describe confirmed cases of colitis caused by C. difficile in two foals in Brazil. Two five-month-old foals with a five-day history of diarrhea after antibiotic treatment for a respiratory disease were treated at the Veterinary Hospital of the Universidade Federal de Minas Gerais. C. difficile A/B toxins were detected, and toxigenic strains of C. difficile were isolated from the foals' feces. The treatment was based on fluid therapy and antibiotics (metronidazole and ceftiofur), and the animals experienced a gradual recovery. The association between the medical history, clinical signs, laboratory exam results and therapeutic success confirmed the diagnosis of C. difficile-associated diarrhea. The present report raises the possibility that C. difficile is also a pathogen in equines in Brazil and highlights the need for up to date routine laboratory protocols for the diagnosis of this disease.

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Apesar da importância de Clostridium difficile como agente causador de diarreia e colite em potros, inexistem relatos confirmados de tal doença no Brasil. O objetivo deste trabalho foi descrever dois casos confirmados de diarreia causados por C. difficile em potros, ocorridos em Minas Gerais, Brasil. Os animais, com cinco meses de idade, foram encaminhados ao Hospital Veterinário da Universidade Federal de Minas Gerais (UFMG) com histórico de cinco dias de diarreia após antibioticoterapia com penicilina para uma possível pneumonia. Ambos os animais foram positivos para detecção das toxinas A/B de C. difficile e isolados toxigênicas de C. difficile foram isoladas de amostras de fezes. Os animais apresentaram melhora gradual com o tratamento baseado em metronidazol e fluidoterapia e receberam alta após sete dias. A associação do quadro clínico, exames laboratoriais e o sucesso terapêutico permitem confirmar o diagnóstico de colite por C. difficile. O presente trabalho chama a atenção para a possibilidade de diarreia causada por C. difficile em equinos no Brasil e reforça a necessidade do diagnóstico para tal infecção na rotina laboratorial.

RESUMEN

Despite of the substantial role of Clostridium difficile in causing diarrhea and colitis in foals, there have been no confirmed diagnoses of disease caused by this bacteria in Brazil. In this paper, we describe confirmed cases of colitis caused by C. difficile in two foals in Brazil. Two five-month-old foals with a five-day history of diarrhea after antibiotic treatment for a respiratory disease were treated at the Veterinary Hospital of the Universidade Federal de Minas Gerais. C. difficile A/B toxins were detected, and toxigenic strains of C. difficile were isolated from the foals' feces. The treatment was based on fluid therapy and antibiotics (metronidazole and ceftiofur), and the animals experienced a gradual recovery. The association between the medical history, clinical signs, laboratory exam results and therapeutic success confirmed the diagnosis of C. difficile-associated diarrhea. The present report raises the possibility that C. difficile is also a pathogen in equines in Brazil and highlights the need for up to date routine laboratory protocols for the diagnosis of this disease.

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Apesar da importância de Clostridium difficile como agente causador de diarreia e colite em potros, inexistem relatos confirmados de tal doença no Brasil. O objetivo deste trabalho foi descrever dois casos confirmados de diarreia causados por C. difficile em potros, ocorridos em Minas Gerais, Brasil. Os animais, com cinco meses de idade, foram encaminhados ao Hospital Veterinário da Universidade Federal de Minas Gerais (UFMG) com histórico de cinco dias de diarreia após antibioticoterapia com penicilina para uma possível pneumonia. Ambos os animais foram positivos para detecção das toxinas A/B de C. difficile e isolados toxigênicas de C. difficile foram isoladas de amostras de fezes. Os animais apresentaram melhora gradual com o tratamento baseado em metronidazol e fluidoterapia e receberam alta após sete dias. A associação do quadro clínico, exames laboratoriais e o sucesso terapêutico permitem confirmar o diagnóstico de colite por C. difficile. O presente trabalho chama a atenção para a possibilidade de diarreia causada por C. difficile em equinos no Brasil e reforça a necessidade do diagnóstico para tal infecção na rotina laboratorial.

RESUMEN

Despite of the substantial role of Clostridium difficile in causing diarrhea and colitis in foals, there have been no confirmed diagnoses of disease caused by this bacteria in Brazil. In this paper, we describe confirmed cases of colitis caused by C. difficile in two foals in Brazil. Two five-month-old foals with a five-day history of diarrhea after antibiotic treatment for a respiratory disease were treated at the Veterinary Hospital of the Universidade Federal de Minas Gerais. C. difficile A/B toxins were detected, and toxigenic strains of C. difficile were isolated from the foals' feces. The treatment was based on fluid therapy and antibiotics (metronidazole and ceftiofur), and the animals experienced a gradual recovery. The association between the medical history, clinical signs, laboratory exam results and therapeutic success confirmed the diagnosis of C. difficile-associated diarrhea. The present report raises the possibility that C. difficile is also a pathogen in equines in Brazil and highlights the need for up to date routine laboratory protocols for the diagnosis of this disease.

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Apesar da importância de Clostridium difficile como agente causador de diarreia e colite em potros, inexistem relatos confirmados de tal doença no Brasil. O objetivo deste trabalho foi descrever dois casos confirmados de diarreia causados por C. difficile em potros, ocorridos em Minas Gerais, Brasil. Os animais, com cinco meses de idade, foram encaminhados ao Hospital Veterinário da Universidade Federal de Minas Gerais (UFMG) com histórico de cinco dias de diarreia após antibioticoterapia com penicilina para uma possível pneumonia. Ambos os animais foram positivos para detecção das toxinas A/B de C. difficile e isolados toxigênicas de C. difficile foram isoladas de amostras de fezes. Os animais apresentaram melhora gradual com o tratamento baseado em metronidazol e fluidoterapia e receberam alta após sete dias. A associação do quadro clínico, exames laboratoriais e o sucesso terapêutico permitem confirmar o diagnóstico de colite por C. difficile. O presente trabalho chama a atenção para a possibilidade de diarreia causada por C. difficile em equinos no Brasil e reforça a necessidade do diagnóstico para tal infecção na rotina laboratorial.